ANS: new tests prioritize prevention
This article was translated by an automatic translation system, and was therefore not reviewed by people.
Luciele Velluto,
Public consultation for the inclusion of mandatory procedures for health insurance goes to the beginning of October
Began yesterday the public consultation of the National Agency of Supplementary Health (ANS) that should define the new procedures for mandatory coverage by health plans from 2010. The highlight of this year is the expansion of the concept of prevention, which has the clear objective to avoid further costs to hospital. An example is the suggestion to double the number of psychotherapy sessions in cases of stress and any number of nutrition assistance for diabetics.
The consultation will remain open for 30 days (until 7 October) and everyone from clients to professionals in health, you can say about what you would like the health plan would have on the list of minimum coverage, it's just access the website www . ans.gov.br.
In the consultation held last year to update the list were recorded 30 thousand shares, according to general manager of product technical assistance agency, Martha Oliveira. "And we expect that number to grow this time because people are more informed about what is right in his plans and made some requests in 2008 just now entering the NSA as a suggestion for inclusion in next year," he says. The new list comes out in December this year or January of next year, going into effect on 2 April 2010.
Among the tests proposed in the consultation of 2008 and which came as a suggestion in the survey this year is the Pet Scan, which allows the checking of new tumors in patients with lung cancer or lymphoma.
The procedure costs around U.S. $ 3 billion and is among the proposals of the ANS to the next listing. "Another item that was the result of user demand is the multi-site pacemaker, which includes the placement procedure and cost of the equipment itself," says Martha.
In the mental health, the number of sessions of psychotherapy for patients with stress, for example, rose from 12 to 24. "Before the cover was only in case of severe illness or hospitalization. Now the goal is that this patient be treated so that the problem is identified, avoiding spending on hospitalization. This applies to all cases in need of therapy and a psychologist, "explains general manager of ANS.
Service
Consultations with nutritionist and speech therapist were also expanded, anticipating a great demand in the public consultation. In the case of diabetes, the patient will have unlimited service with a nutritionist. "It's a way to manage the care that person needs to have with food," says Martha.
Also new is the suggestion of inclusion of thoracic surgery for video - which had already been adopted by many health plans and reduced hospitalization costs due to less invasive procedure - and the bone marrow transplant donor external, which is now only covered in case of bone marrow donated by the patient.
In the public this year is also included oral health (for the dental plans). The two main suggestions for inclusion in the list in this area are covering the crown (piece of porcelain that covers the tooth) and block (reconstruction of the tooth with metal), including also the prosthesis.
Reset
For the president of Abramge, Arlindo de Almeida, there is no way to include new procedures and more visits without transfer to the consumer. "We are not against progress, but these tests are added to others and the trend is the rising cost. The problem is that away from people who would like to have a plan and can not because of price, "he says. He fears that some procedures are required without increasing the costs of the plans.
PROPOSALS
EXAMS
PET SCAN ONCOLOGICAL
Mandatory coverage for patients with lung cancer
and for patients with lymphoma
CONSULTATIONS
FONOAUDIOLOGIA
Mandatory coverage of 24 consultations per year for patients with hearing loss, stuttering or taquifemia, Specific developmental disorders of speech and language, with cleft palate, lip or cleft palate, with dysphagia for patients with facial anomalies. For cases not covered above,
mandatory coverage is six visits per year
NUTRITION
Mandatory coverage, unlimited number of queries, when the patient has a confirmed diagnosis of diabetes, having made at least two doctors specializing in the last 12 months have made at least two tests for glycated hemoglobin in the last 12 months and must have at least one fundoscopy in the last 12 months. For cases not covered above, the minimum coverage required is 6 consultations per year contract
ORAL HEALTH
CROWN
Mandatory coverage of placing the piece of porcelain to coat the teeth, including the prosthesis
BLOCK
Mandatory coverage of metallic restoration that restores the tooth
MENTAL
SESSIONS PSYCHOLOGIST AND / OR OCCUPATIONAL THERAPIST
Mandatory coverage of 40 visits per year contract when the patient has a diagnosis of schizophrenia, schizotypal and delusional disorders, with a diagnosis of disorders of children and adolescents diagnosed with disorders of psychological development
SESSIONS OCCUPATIONAL THERAPIST
Mandatory coverage of 12 visits per year contract, when the patient has a diagnosis of dementia or retardation
PSYCHOTHERAPY SESSION
Mandatory coverage of 24 sessions per year contract when the patient has a diagnosis of neurotic disorders, disorders related to stress, diagnosed with behavioral syndromes associated with physiological dysfunction and physical, with a diagnosis of mood disorders and diagnosis of disorders due to SUD
PROCEDURES
Multisite pacemaker implantation
For patients with ejection fraction less than or equal to 35% in sinus rhythm with bundle branch block and left patients followed in a referral outpatient clinic for at least three months, with cardiac dyssynchrony
CHEST SURGERY FOR VIDEO
Mandatory coverage for patients who need this procedure
Opine on procedures that should be included, just look for public consultation in paragraph 31 of the NSA site (www.ans.gov.br)
Source: Jornal da Tarde
This article was translated by an automatic translation system, and was therefore not reviewed by people.
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